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Home My WebLink About2204-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No..Z..20~.9 ............ Date .................... D. ec~er.....9. ......... , 1~)...6~ THiS CERTIFIES that the building located at ...J~%~-.~..1.~_~..1~ ................................. Street Mop No..~.°.~.~.°..Z..!.~'o ....................... Lot No...~.~ ........ ~o~.~,......mz. ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........................................ OO.t,,......] ......... , 19.t~.. pursuant to which Building Permit No. dated ................. ( ............... 0¢~;.-,..] ......... , 19..~.~., was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ......... P~.i.v.a.t.e...one...£a~il~...l~eilLng ........................................................................................ The certificate is issued to ..... ]~r~e. de~.i~L.~c..~[al~.old..~8.~.~le. ........................ O~Rf~,~..~ ............... (owner, lessee or tenant) of the aforesaid building. H.D.Approval Deo 8 196~ by R. Villa Building Inspector ~ FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2204, Z Date ................. O~t, Ob~- ......... 3 ............ 196.~ .... Permission is hereby granted to: QueJ~er .~lclg~,. ]~J,l~ter~.... ~'.C.... J~,..&. ~,...l~eeze ................ A~uebog. ue .......................................... to ... Bu. lld..r, ew...., c~e...$~£1~*...d~ce11I~ ................................................................................ at premises located at ..... .T~o¢..2*~.*...~O~he~d.*~hOZ*~2 ............................................................. ............................................... (.Sega.-.P~'~p.)- ( ~.t.n...Read.).. Gr een~pe~,.t, ................................ pursuant to application dated .................... 0~o~3e~ ....... ~ .................. 19..{o~., and approved by the Building Inspector Fee ~0..00 ............. t~unomg nspecTor J scm SUFFOLK COUNTY DEPARTMENT OF HEALTH Date ........ Building Permit Ne. , TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure located at ~,~7,~. ~, _~,~,7-?&? ~,~ ~ si.,,, ~ ~,/~ · deed location) have been inspected by this Department and found to be satisfactory. "' bistrict Engineer FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y? Examined ........................ (..~.'./~....., Approved ............................. --~.~.~...-~.., 19....~.~Permit No...../~.~..~r~.~..~...'~... ........ Disapproved a/c ......... ..~,~rr.....%Z~.~.....%L:z......._z........~ ...... Application No. ~ ~ ~ AP?LICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing Ioca¢ion of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in pa rt for any purpose whatever until a Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Sign~ature of applicant, or name, if a corporation) Aquebogue (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. C on..t.X~.c.t or. .............. Name of owner of premises ....~..,.~..~..,R~.e.s.e,, ................................................................. ~ ................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: .3.~ff~...~.l.q] ...... ).tkO. lt~.~.~.... Lot No: ...~3 ............. Street and Number ~.v...t2 .~,Q.~d~ ~./.~' ~[a~Y~ I~os,~.~ Gr¢:?,ezzpor. I~ ................. Municipality 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy V..~C,~...la~d ........................... . ................... b. Intended use and occupancy oz~_r ~amily;. dwell~.~g 3. Nat(Jre of work (check which applicable): New Building ...x,~xo~. ..... Addition .................. Alteration .............. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ..... ~...O..O..0.....P./.~. .............................. Fee .......... ~.0.. ...................................................................... (to be paid on filing this application) 5~ If dwelling, number of dwelling units ...........O.~ ............. Number of dwelling units on each floor ......................... If garage, number of cars .......................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature.and extent of each type of use ............................. 7. Dimensions of existing structures, if any: Front .......................... Rear .......................... Depth ........................... Height ............................ Number of Stories .......................................................................................................... Dimensions of same structure with alterations or additions: Front ................................ Rear ............................. Depth ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front ...........~.7. ................. Rear ............ 3.7. ........... Depth ....... 2~. ............ Height ............................ Number of Stories...O.n~ ......................... 9. Size of lot: Front ........ ,130 ................. Rear ............................ Depth .....Z.~,~.~...~..~ ................. 10. Date of Purchase ................ .];.9..~..~.. .............................. Name of Former Owner ........... .0..:...',c-}.~..~. ........................ 11. Zone or use district in which premises are situated ...... !!..~.!!...~.i..~..~. .................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............. ..~.,O. ................................ 13. Name of Owner of premises ~.o& 1-10l~ac~q.~ ........... Address ....L,y.12.~.l~,O.Qk ..................... Phone No ................. Name of Architect ...................................................... Address ............................................ Phone No ................. Name of Contractor (~.9.9*]*;..~.lt....~;i,.Clg.G. ....................... Address ......J~ft:~,fl~.Ql~.9,ff ................ Phone No ................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr~ property lines. Give street and block numbers or description according to deed, and show street names and indic whether interior or corner lot. STATE OF NEW YORK, ) COUNTY,OF .~O.lk .......... ) S.S. .................. . .......... ~3-.Qb.t.l..]~c~a.h ............................................... being duly sworn, deposes and says that he is the applicc (Name of individual signing application) (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to aerform or have p~rformed the said work and to make and f this application; that oil statements containec~u~Cit~tl~jsBola~licetion are true to the best of his knowledge and bell and that the work will be performed in t~l~ri~q~i~ltaieSt~of~e~'~ the application filed therewith. Sworr to b'efore me th s ~o, 52-0344963, S~ffolk county ~ ~ Nolary Public, ..~....~..,.~~ (Signature of applicant) e FOP~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ................... ./.~.?F~'m~ ....... , 19..~...-.~. Approved ..................... ,9.. Permit No ..... Disapproved a/c ............................................................................................ (Build~ Inspector) Application No ........ APPLICATION FOR BUILDING PERMIT Date ........................ .0...O. ~? .b, .?.~. ,....3. ........ , 19,.~..3. ........... INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in pa rt for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demol, ition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. Quake~ R~d~e Buil~lers (Signature of applicant, or name, if a corporation) Aq'tzebogue (Address of a~plicant) State whether applicant is owner, lessee~ ooent, orchitect~ engineer~ general contractor, ele~-ricion~ plumber or builder. Contractor : ~ Name of owner of premises ...F.~...I~.~...~.e. xe.-.f%,e. ..................................................................... ":, ............................................ If applicant is a corporate, signatuFe of duly authorized officer. (Name and ~itle of corporate officer) 1. Location of land on which proposed work will be done. Map No: ..~...8...~..3...~.l.~.?.....~..h°.?.e.~.... Lot No: ...~3. ............. Street and Number ......'.?...V.t...~.O...a..~..~....~.../..~......!4a~r~...~...O..a...~.-t ....... .~.r.~.e.~..o.~.t,.......' .................................................. Municipality 2. State existlng use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy V&~al'2,~. b. Intended use an~ occupancy OD~I.~ ~'al~:Lllg' c'[~'ellJ, D.g /, 3. Nature of work (check which applicable): New Building ...,~c,,~. ..... Addition .................. Alteration ............. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ..... ,,~$..O..O.0...~.~ .............................. Fee ........... ~.0. ..................................................................... (to be paid on filing this application) 5. If dg, elling, number of dwelling units .......... ,O~ ............. Number of dwelling units on each floor ........................ If garage, number of cars ......................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front .......................... Rear .......................... Depth .......................... Height ............................ Number of Stories ......................................................................................................... Dimensions of same structure with alterations or additions: Front ................................ Rear ............................ Dep,th ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front ..........,~.~. ................. Rear ............ .,~.~. ........... Depth ....... ~ ............ Height ............................ Number of Stories...~i'~$. ........................ 9. Size of lot: Front ........ '1,,,~0. ................ Rear ............................ Depth -.].~3~',.,],~.,~. ................. 10. Date of Purchase ................ .~..~..~..~. .............................. Name of Former Owner ........... I~.,,..~..l~g..e. ........................ 11. Zone or use district in which premises are situated......!!A!!...~.~..~ .................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............. .~..~. ............................... 13. Name of Owner of premises ..~,.~.,J[,.~J.e.~l~.~ ...........Address .,..[~n.~.g.O~ .................... Phone No ................. Name of Architect ...................................................... Address ............................................ Phone No ................. Name of Contractor ~.'1,18,~:.~.~..~$.~g.~ ....................... Address ......~CJ.~l.e~OJJ~¢ ................ Phone No ................. PLOT DIAGRAM Locat'e clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr( property lines. Give street and block numbers or description according to deed, and show street names and indic( whether interior or corner lot, STATE OF; NEW YOR,I~, ) COUNTY OF .~,~.~.;~,~..,~ ..........) S.S. ............................ ~T.o.~0,..~I~ ............................................... being duly sworn, deposes and says that he is the applicc (Name of individual signing application) above named. He is the ........ .~...O..~..~:..~:~.~..~,~. ..................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duJy authorized to perform or have performed the said work and to make and f this applicbtion; that all statements contained ,in rthS¢~(~plication are true to the best of his knowledge and bell and that the work will be performed in thez~m~ Cb¢%~gb in the application fi:led therewith. Sworn to before me this t,umm,ssiofl Expires ........................ ~'~"7 ';'"' . % ~,~;r~ ~ ,~g~ ............................. , ....... , ................................................... Notary Pubhc, ...~(:.,;..:.:. ....... :.~ .................... :;'""'~'~Y ~ ............. ~J'~ature of appl,cant)